Making a human right to tobacco control: Expert and advocacy networks, framing and the right to health

Abstract

This article addresses the proliferation of human rights in international public health over the last 20 years by examining recent attempts at framing the global smoking epidemic as a human rights problem. Rather than advocating in favour or against human rights-based approaches, the article purports to understand how and why such approaches are being articulated and disseminated. First, it argues that the representation of the global smoking epidemic as a human rights issue has been the product of a small, international network of public health experts and lawyers: the human rights and tobacco control collective or community (HTC). The article describes in particular the HTC's membership, its style of thinking and its efforts to articulate and disseminate human rights-based approaches to tobacco control. Second, the article argues that the aim of the HTC when framing tobacco control as a human rights issue was not to generate public attention for and the political will to tackle the global smoking epidemic, as the literature on framing and human rights presupposes. Instead, as the article shows, the HTC framed tobacco control as a human rights problem to tap into the powerful, judicial monitoring and enforceability mechanisms that make up international human rights.

Keywords:

• human rights
• global health
• tobacco control
• expert networks
• framing
• right to health

Acknowledgements

First and foremost, I would like to thank the tobacco control advocates and human rights experts interviewed for this research for their interest and the time spent answering my queries. Furthermore, I thank Colin McInness, Simon Rushton, Owain Williams, Kelley Lee, Adam Kamradt-Scott and two anonymous reviewers for their helpful comments on earlier drafts of this article. I also gratefully acknowledge the financial support from the European Research Council under the European Community's Seventh Framework Programme (Ideas Grant 230489 GHG). All views expressed remain mine.

Notes

1. This assertion comes with three caveats. First, there have been instances over the last 40 years when both the tobacco industry and the anti-smoking movement have used a rhetoric or language of rights, i.e., have used linguistic expressions like ‘the right to smoke’ and ‘the right to a smoke-free environment’ as arguments in policy debates about smoking (cf. Jacobson and Soliman 2002, Berridge 2007, Brandt 2007). This, however, is quite different from the HTC's efforts to use a legally recognised and defined human right to health together with the existing national and international human rights monitoring and enforceability mechanisms. Second, some international human rights institutions had already made a link between human rights and tobacco control in the late 1990s and early 2000s (Crow 2004). In particular, the UN-CESCR has, from 1999 onwards, sometimes mentioned, both in its General comment 14 on the right to health and in its reviews of States’ reports, that information campaigns on the dangers of smoking are a measure through which states can fulfil the right to health found in article 12 ICESCR. These few mentions did not, however, amount to any systematic or concerted effort to use the right to health to improve tobacco control. Third, in 1999, the WHO Tobacco Free Initiative sought to ally with UNICEF and use the 1989 UN CRC to support its call for increased efforts in tobacco control. A two-day workshop was held and a report entitled Tobacco and the Rights of the Child was published (WHO 2001), but neither had any impact and the attempt to frame tobacco control as a children's rights issue was not pursued further (Yach 2010).

2. Some tobacco control advocates are still uncertain as to whether the language of human rights will become important in their field. As Matthew Myers (2010), the current President of the Campaign for Tobacco Free Kids which currently funds the work of human rights lawyers on smoking, explains:

I think it is too early to know whether human rights will become a powerful tool or not (…) We are testing them out (…) It's too early to know (…) Up to this time with a couple of exceptions it has not been as successful as we had hoped, but that does not mean it won't be (…) It is still a nascent discussion.

3. Members of the HRTCN include: Douglas Bettcher, Chris Bostic, Pascal Bovet, Oscar Cabrera, Richard Daynard, Rangita de Silva de Alwis, Carolyn Dresler, Tom Glynn, Patricia Lambert, Harry Lando, Judith Mackay, Hadii Mamudu, Stephen Marks, Benjamin Meier, Kathy Mulvey, Helena Nygren-Krug, Marty Otanez, Gemma Vestal and Yehenew Walilegney (HRTCN 2011a).

4. HTC members who have been involved in the field of global tobacco control for a decade or more include: Douglas Bettcher, Chris Bostic, Pascal Bovet, Richard Daynard, Patricia Lambert, Tom Glynn, Judith Mackay and Kathy Mulvey.

5. HTC members with a previous experience of the field of international human rights include: Oscar Cabrera, Rangita de Silva de Alwis, Stephen Marks, Helena Nygren-Krug and Yehenew Walilegney.